This invention relates generally to surgical apparatus and procedures. More particularly, it relates to methods and apparatus for treatment of unwanted varicose, reticular and spider veins in a venous system of a patient.
Spider veins, reticular veins and varicose veins are common conditions that occur in many humans and are typically found in the limbs of the human body, in particular the legs.
Spider veins (i.e., telangiectasiae) are small, dilated blood vessels near the surface of the skin. They can develop anywhere on the body but commonly are found on the face, around the nose, cheeks, and chin, or on the legs, in particular on the upper thigh, below the knee joint, and around the ankles. Reticular veins are also known as feeder veins and are dilated veins that appear bluish or greenish in colour and are visible to the naked eye. Spider and reticular veins generally consist of small, thin, dark-colour veins that lie close to the surface of the skin. Usually they measure only a few millimeters. They often have a web or sunburst pattern, but may also appear as random line segments.
Varicose veins are larger than spider veins. Varicose veins are bulging veins that are typically 3 millimeters (mm) or more in diameter. They generally are veins that have become enlarged and twisted. Varicose veins are most commonly found on the leg, although varicose veins can occur elsewhere on the body. Varicose veins usually have a blue or purple colour and may protrude above the surface of the skin. These veins have usually lost their ability to carry blood back to the heart and blood often accumulates in these veins.
A number of factors can contribute to the development of varicose and spider veins, including heredity, obesity, posture, hormonal shifts, excessive heat, and standing or sitting for a long periods of time.
Reticular and varicose veins may cause patients to experience symptoms such as aching, burning, swelling, cramping, and itching. More serious complications of varicose veins can include thrombophlebitis, dermatitis, haemorrhage, and ulcers.
If certain varicose veins are not treated, blood clots may form in the vein, and phlebitis or inflammation of the inside lining of the vein may occur.
Equally, many patients seek medical treatment of varicose veins and spider veins for cosmetic reasons.
Various approaches have been developed to treat spider, reticular and varicose veins. These treatments include vein removal for severe cases; for example, using techniques such as ambulatory phlebotomy or vein stripping. Such operations can be painful and uncomfortable for patients in the hours and days following surgery.
Endovenous laser and radiofrequency ablation are also known methods of treatment. However, these methods require specialized training for practitioners and expensive equipment. Follow-up treatment for smaller branch varicose veins is also often needed in the weeks after the initial procedure. Complications for radiofrequency ablation and endovenous laser treatment include bruising, burns and paraesthesia.
In less complicated cases, elevation of the legs and use of support hosiery may be sufficient therapy to stop or slow the progression of the varicose veins.
Sclerotherapy is a well known treatment for smaller varicose and spider veins lying close to the surface of the skin. In this procedure, the affected veins are injected with a sclerosing solution, such as sodium tetradecyl sulfate (STS). The sclerosing solution causes inflammation and subsequent sclerosis of the vein. The sclerosis results in localized scarring of the veins, which forces re-routing of the blood away from the affected veins.
When treating veins with a sclerosing solution, the sclerosing solution may not stay in the desired portion of the vein being treated and may leak outside of the vein, causing skin ulcerations. Hyper-pigmentation may also occur as a result of the leakage of a blood component, hemosiderin pigment, from the treated vein. The sclerosing solution can also cause inflammation in the region where the solution was injected.
In order to limit postoperative inflammation, the medical practitioner usually applies compression to the treated area immediately after sclerosing solution has been injected. The patient is also usually required to wear support hosiery for a number of days, e.g., for 48 consecutive hours after treatment and then during waking hours for seven more days.